Carbs? Confused.

[doctorqwerty]

Newly diagnosed.
Advised to eat carb based meals, but watch sugar and fat content levels.
Reading discussions on here makes me wonder if i should be watching carbs intake too.
Any advice out there? Or do carbs affect different people and types differently?
Help me obi-wan you're my only hope!

 

[IanD]

Who advised you? Were you given the NHS "Healthy Eating for Diabetics" booklet? I followed the system faithfully for 7 1/2 years - the Dr who gave me the diagnosis frightened me with heart attacks, strokes, blindness, amputation, kidney disease ... so I was afraid not to comply with the standard recommendations.

Until the predicted complications occurred - beginning of retinopathy & crippling neuropathy causing intense leg muscle pain.

I then found this forum & the reduced carb recommendation. The neuropathy has cleared allowed me to resume my active life. I now consider the standard dietary advice to be WRONG & DANGEROUS for diabetics.

The point is that carbs metabolise to glucose, & blood glucose causes the problems.

 

[doctorqwerty]

Yes it was the booklet and NHS advice.
I was told the same about failing eyes, kidneys shot, feet gone.
I walked out thinking thats it...life is over.
Reading things on here though has made me quickly realise that maybe i have to address my condition in a different way.
So any advice anyone can give would be really very much appreciated.

 

[catherinecherub]

Hi doctorqwerty,
You need a meter and test strips to see how foods affect your blood sugar levels. Your doctor may provide this . If not you need to buy one and hope that he will provide test strips in the future.
Everyone is different and you will see by reading posts on the forum that some people can get away with moderate carb intake whilst some have to low carb. Without a meter you will not know what to avoid.
Hope this helps.
Catherine.

 

[IanD]

Yes. That depression lasted months, as I went out believing I had the illness that would cause my death. My helpful Dr finished the interview by computing my probability of a heart attack at 25%.

I was 61. Now I shall be 70 in March & after recovering from that neuropathy by rejecting the NHS diet & eating sensibly, I am still playing a good game of tennis at club standard. I shall be playing tonight, weather permitting. Last April I had to get the AA to drive me home from Birmingham because of leg pain. The Dr just gave me quinine for cramp (useless) & considered my diabetes control was satisfactory. He is now very interested in my improvement & the way it was achieved.

All I did initially was to cut the visible carbs (bread, potatoes, rice, pasta) & increase veg & protein. In 3 months I lost a stone, dropped cholesterol from 5.4 to 4.3 & overnight blood sugar from around 7 to around 5.5.

I'm sure you will get helpful answers to your questions on this forum.

 

[ally5555]

Ian - when you talk about theis NHS healthy eating book what is it - you may be suprised to hear i have never seen it ? Never used it so who produced it - I have asked a few colleagues and they dont know what it is either. Would be interested to look at it!

 

[IanD]

Ian - when you talk about theis NHS healthy eating book what is it - you may be suprised to hear i have never seen it ? Never used it so who produced it - I have asked a few colleagues and they dont know what it is either. Would be interested to look at it!

I was given it last year by a dietitian.

 

[IanD]

The booklet is official & professionally produced by dietitians:

 

[IanD]

Ally, observe that the recommended starchy foods will "help to maintain blood sugar levels."

Perhaps I shouldn't disagree with that statement. But surely we should be aiming to reduce, NOT maintain BS levels :!: :?:

I'm sure Mr Sidhu will send you a copy of the booklet.

 

[ally5555]

thanks ian - so that it is a local booklet - is there a meal plan , recipes , portion sizes etc .

That page is useless in isolation without portions - most of those carbs are lower GI
It is not a booklet that is given out across the nhs . Unles england has one i do not know of any booklet apart from those dolled out by drug co and dmuk.

From the dietitians point of view the system is against them - they may have given you a 20 minute slot - quite useless and offer no follow up , that is if you dont have to wait 6 months for an appointment. The profession has a priority to in patients who have massive nutritional problems so in many hospitals out patients are seen as less important. It is not the fault of the dietitians but the nhs system not understanding the high priority of the patients. This does not help any of you - i know that some depts have stopped seeing overwt pts because they cannot cope. I really think that if you had a behind the scenes view of a dietitians role and the frustration the profession is feeling you may see how difficult it actually is. It sounds very simple to sit in a clinic and see people - I see 10 pts in a session . a mix of new and follow up and i am mentally drained at the end .

For all the talk about food and health nutrition is not a main priority in the nhs

It is not a booklet that is given out across the nhs . Unles england has one i do not know of any booklet apart from those dolled out by drug co and dmuk.

TBH I think the name should be removed of the person who gave you that and i hope the mods do that because I would hate to see that person bombarded from here.

I give individual plans to people - one i did last week would horrify anyone on here but it was for a 92 year old man - and was basically just sugar free and no carb counting. If it was posted on here would cause a fury but at 92 he told me the onlything he would stop was sugar in his tea!

Sorry if that was a rant but Dietitians on the whole are a hard working, well qualified profession that is struggling in a sea of psuedo nutritionists/experts with limited time and resources.
I wish a few more would post but they won't when they get accused of causing every problem under the sun - unfairly in my opinion.

 

[IanD]

I have removed the dietitian's name & contact.

 

[IanD]

thanks ian - so that it is a local booklet - is there a meal plan , recipes , portion sizes etc .
"Local" is a huge area of West London. According to the booklet, manage diabetes by:
healthy eating; medication (if prescibed); physical activity.

Meal plan - no;
recipes - no;
portion sizes - fruit & veg: 5 a day with portion sizes defined;
meat, fish & alternatives - portion sizes defined;
starchy foods - not defined, but 1/3 of plate;
dairy - defined;
fat & sugar - not defined but to be limited every day (choose fewer sugary foods & drinks);
diabetic foods - none;
salt - low;
alcohol - defined

That page is useless in isolation without portions - most of those carbs are lower GI

They may be "lower GI" but I only discovered GI years after my dietitian appt & realised the reason for recommending basmati & granary bread, etc.

It is not a booklet that is given out across the nhs . Unles england has one i do not know of any booklet apart from those dolled out by drug co and dmuk.

For all the talk about food and health nutrition is not a main priority in the nhs

It is not a booklet that is given out across the nhs . Unles england has one i do not know of any booklet apart from those dolled out by drug co and dmuk.

Sorry if that was a rant but Dietitians on the whole are a hard working, well qualified profession that is struggling in a sea of psuedo nutritionists/experts with limited time and resources.
I wish a few more would post but they won't when they get accused of causing every problem under the sun - unfairly in my opinion.

The net result for me was what amounted to a diet high in carbs, amounting to about double the amount you eat as a non-diabetic. And I am a professional scientist - what hope have diabetics of eating a healthy & appropriate diet when we get such advice?

I'm not getting at dietitians, but it seems that the science on which "your" training is based is seriously flawed.

It seems to me that you personally would reject that booklet. Can you send me your own recommended booklet/diet sheets? I'll PM my address.

 

[tubolard]

I received a similar booklet from my dietitian, (un)fortunately without the pretty colour pictures (gave Dragonette something to colour in :twisted: ), mine pretty much spelled out low GI for me (Especially as the heading on page 3 is How to eat the Low GI Way ).

Similarly, my leaflet recommended portion sizes for fruit, veg, and meat, but little else. So, armed with little knowledge it was yet more trial and error for me as I adapted to a new diet. Catherinecherub pointed out a couple of good references for a low GI which I duly went out and bought, which is the first time I actually got portion advice for grains. As I said in another post, I reduced, by a third, portion sizes for pasta and rice. On the occasions we have potatoes I try and limit myself to a couple of small new spuds (Christmas day was an exception when I allowed myself two tablespoons of mashed and a couple of small roasties - had plenty of brussels though which made me as popular as the outlaws rather aged dog )

I've said this to Ally before, and I hope she won't mind me repeating it in public, it is a crying shame that dietitians aren't giving more portion advice which, IMO, is absolutely vital especially when starting out on a new diet. I understand from Ally that she does devise meal plans for her patients though.

My experience with dietetics is exactly as Ally has reported, a 20 minute introduction session, followed by periodic 10 minute reviews (I have my first review on the 8th and my appointment letter tells me the session will last 10 minutes). Ally has also reported in another thread of a colleague who has been set a target of seeing a patient every 9 or so minutes (can't remember exactly) which you have to agree is absolutely ridiculous. I mean, I like to think that I'm not unintelligent, but I don't think 10 minutes is a long enough time to discuss any weaknesses in my diet and to go through any improvements I might make (if any - here's hoping)

I believe the setting of targets can be useful, however they do need to be clinically realistic. It is high time the Diabetes National Strategy team actually started listening to people with diabetes, who experience the levels of care being given by the NHS.

Regards, Tubs.

 

[sugarless sue]

I did see a dietician soon after being diagnosed.I showed her a food diary that I had been keeping and we discussed diet.I have ,however ,never been offered a review of my diet since that initial meeting.

 

[catherinecherub]

I have had diabetes for over 5 years and have never seen a dietitian. The diabetic nurse at my GP practise gave me information about diet and I know she is available if I need her. I have never been referred to a chiropodist either but I do have an anual foot check and eye check. I have not been referred to a specialist .

 

[hanadr]

You'll be "amazed" to read that I was NEVER given anything, not even a formal advice sessiom. Maybe because I'm married to a T1
However here's my Carbs 101 again
Comments on this welcome
Here goes Carbs101
A carbohydrate is a molecule made up of atoms of carbon, hydrogen and oxygen bonded chemically. The proportion of hydrogen to Oxygen is usually, but not always 2:1. Among the simplest carbohydrates are the simple sugars, or monosaccharides. They have a carbon chain spine, which often forms a ring, with hydrogen and a group which is the “free sugar" group attached. Simple sugars with carbon chains of from 2 to 10 carbon atoms are known. If 2 monosaccharides are chemically bonded together, a disaccharide is formed. thus Glucose and fructose, with a 6 carbon and a 5 carbon ring respectively, both monosaccharides combine to form sucrose, a disaccharide. Polymers of many monosaccharide units include, starch and cellulose.
The only carbohydrates of importance in the diabetic diet are those based on, or easily converted to glucose. This does not include fructose. Fructose is Very sweet and tastes nice, but tends to encourage formation of triglycerides in the liver. This is a pity.
For every molecule of Sucrose (table sugar) you consume, only half becomes blood glucose.. The other half is fructose and is metabolised along different pathways. However, for every molecule of starch you consume, 100% becomes blood glucose. Thus effectively, starch is worse for blood glucose levels than table sugar, weight for weight.
The so-called complex carbs, tend to be made up of starches and some cellulose (which is also a carb, but not digestible)
A whole heap of cellulose, otherwise known as dietary fibre, won't raise your BG, but a whole load of starch WILL.
To make remembering all this more difficult, there are 2 kinds of starch chains, Amylose and amylopectin.
Amylose is formed of straight chains, which coil up tightly and resist cooking
Amylopectin is formed of branched chains, which are loosely wound.
We don’t have a mechanism for digesting starch in the raw state, it must be cooked first. So starches containing a lot of amylose in the mix are slower to digest, the so called low GI starches.
Although, amylose will be broken down 100% into glucose, it happen slowly.
Typical starches contain about 20% amylose and 80% amylopectin. Starches from different plant sources vary somewhat.
Unless you want to study biochemistry, a good way to remember which carbs to eat, is Sugar goes 50% to BG FAST
Starch goes 100% to BG Slower.
The only truly GOOD carb for a diabetic is Cellulose, which we can’t digest at all. It’s dietary fibre, or roughage and keeps the gut working, giving it something to push on.l

 

[Katharine]

Very similar booklets are given to patients in Ayrshire by dieticians, nurses and doctors. There is nothing different from the usual food standards agency rubbish. The American College of Physicians plate which is one half low starch/salad veg, one quarter lean protein and one quarter starch is a considerable improvement.

 

[Trinkwasser]

Very similar booklets are given to patients in Ayrshire by dieticians, nurses and doctors. There is nothing different from the usual food standards agency rubbish. The American College of Physicians plate which is one half low starch/salad veg, one quarter lean protein and one quarter starch is a considerable improvement.

Mine wasn't even a booklet, just an A4 folded page (and not even absorbent enough to wipe with)

Seen the Harvard Food Pyramid? It's a bit more realistic

http://www.hsph.harvard.edu/nutritionsource/index.html

To the OP, if you want to try an experiment eat the diet you have been prescribed while doing this

http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

then try eating in a way that impresses your meter

you will inevitably find significant differences and over time you will find a significantly different outcome: a friend was told she'd be on insulin in three years, five years ago - she is now on NO medication, has lost a mass of weight and most of her numbers including lipids and blood pressure are within normal range. She is by no means unusual.